The advantages of cervical disc replacement for the treatment of degenerative disc disease

Significant progress has been made in lumbar and cervical disc replacement therapy. Several cervical disc prostheses have recently gained FDA approval. Although arthroplasty has not been previously described in the thoracic spine, selected patients with long-segment fusion to the level of C-7 have altered cervicothoracic and upper thoracic biomechanics and may benefit from motion-preservation therapy for T1–2 disc herniation. Currently, FDA-approved prostheses are indicated only for patients with single-level degenerative disc disease between C-3 and C-7 and no history of cervical arthrodesis. The authors describe a 52-year-old woman who had previously undergone C3–7 fusion and returned 4 years later with symptoms of C-8 myeloradiculopathy and radiological evidence of T1–2 degenerative disc disease. She underwent T1–2 arthroplasty in which a Prestige artificial cervical disc was placed via an anterior cervicothoracic approach. Motion at C7–T1 and T1–2 was preserved, and the patient made an excellent clinical recovery.

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Two-level total disc replacement with Mobi-C(r) over 3-years

Coluna/Columna ◽

10.1590/s1808-18512014130200452 ◽

2014 ◽

Vol 13 (2) ◽

pp. 97-103 ◽

Cited By ~ 4

Author(s):

Reginald Davis ◽

Pierce Dalton Nunley ◽

Kee Kim ◽

Michael Hisey ◽

Hyun Bae ◽

...

Keyword(s):

Degenerative Disc Disease ◽

Total Disc Replacement ◽

Adjacent Segment Degeneration ◽

Disc Replacement ◽

Cervical Disc ◽

Adjacent Segment ◽

Artificial Disc ◽

Disc Disease ◽

Degenerative Disc ◽

Surgery Rates

Objective: To evaluate the safety and effectiveness of two-level total disc replacement (TDR) using a Mobi-C(r) Cervical Artificial Disc at the 36 month follow-up. Methods: a Prospective, randomized, controlled, multicenter clinical trial of an artificial cervical disc (Mobi-C(r) Cervical Artificial Disc) was conducted under the Investigational Device Exemptions (IDE) and the U.S. Food & Drug Administration (FDA) regulations. A total of 339 patients with degenerative disc disease were enrolled to receive either two-level treatment with TDR, or a two-level anterior cervical discectomy and fusion (ACDF) as control. The 234 TDR patients and 105 ACDF patients were followed up at regular time points for three years after surgery. Results: At 36 months, both groups demonstrated an improvement in clinical outcome measures and a comparable safety profile. NDI scores, SF-12 PCS scores, patient satisfaction, and overall success indicated greater statistically significant improvement from baseline for the TDR group, in comparison to the ACDF group. The TDR patients experienced lower subsequent surgery rates and a lower rate of adjacent segment degeneration. On average, the TDR patients maintained segmental range of motion through 36 months with no device failure. Conclusion: Results at three-years support TDR as a safe, effective and statistically superior alternative to ACDF for the treatment of degenerative disc disease at two contiguous cervical levels.

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Cervical sagittal alignment after Prestige LP cervical disc replacement: radiological results and clinical impacts from a single-center experience

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-03962-x ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Xiaofei Wang ◽

Yang Meng ◽

Hao Liu ◽

Hua Chen ◽

Beiyu Wang ◽

...

Keyword(s):

Sagittal Alignment ◽

Disc Replacement ◽

Cervical Disc ◽

Adjacent Segment ◽

Single Center ◽

Disc Disease ◽

Sagittal Vertical Axis ◽

Cervical Disc Replacement ◽

Cervical Sagittal Alignment ◽

The Impact

Abstract Background Cervical disc replacement (CDR) has been widely used to treat one- and two-level cervical degenerative disc disease. Studies have shown the effectiveness of CDR in preserving range of motion (ROM) and delaying adjacent segment degeneration (ASD). Cervical sagittal alignment is an important factor affecting favorable clinical outcomes in cervical spine surgery. This study aimed to explore whether cervical sagittal alignment can be maintained after CDR and to identify the impact of cervical sagittal alignment on outcomes after CDR. Methods This was a single-center, retrospective study. 132 patients who underwent one-level CDR were included. Cervical sagittal alignments, including cervical lordosis (CL), segmental alignment (SA), sagittal vertical axis (SVA), T1 slope (T1s), and T1s minus CL (T1s-CL), were measured. The effects of cervical sagittal alignment on the CDR outcomes were analyzed. Patients were divided into the heterotopic ossification (HO) group and ASD group to determine the potential impacts of cervical sagittal parameters. Results The cervical sagittal alignment parameters, except for the SVA, were significantly improved after CDR and showed decreasing trends at the last follow-up. Significantly higher CL and T1s were found in patients with better ROM after CDR. SVA ≥ 20 mm increased the risk of anterior HO (odds ratio = 2.945, P = 0.007). Significantly kyphotic SA and lower T1s values were found in the ASD patients than in the non-ASD patients (P < 0.05). Patients with ASD at the inferior level showed significantly worse CL (P < 0.05). Conclusion CDR had limited function of improving cervical sagittal alignment. Poor cervical sagittal alignment after CDR was associated with HO, ASD, and less ROM.

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